The LONGEVITY Doctor: Are You Actually HEALTHY? 70% Of The Population Is NOT | Dr. Peter Attia

you talk to a person the day before they're going to die they would give anything and everything for more chance at life the best-selling author and host the number one Health and Wellness podcast on purpose with Jay Shetty could you walk us through what it feels like to think you're healthy to maybe even feel you're doing okay but in reality there's something going on behind the scenes yeah I mean I think there were two sort of things that were a wake-up call for me and neither of these things happen immediately I think it's just sometimes the realization that happens immediately so the first one is I'd always been an athlete my whole life insanely active potentially even you know active to an unhealthy level and you know the focus of that Obsession had always shifted but at the point in the story that we're talking about at this point I was sort of a ultra distance swimmer so I was you know probably in the Water Swimming 24 to 28 hours a week plus you know other types of training yet you know I found out this is probably around 15 years ago that well actually on top of that I was sort of insulin resistant I was overweight and again not that I didn't know I was overweight you sort of you can realize that but but that I was sort of insulin resistant and you know that's sort of the first step up on the way towards type 2 diabetes it was really at that time that I also I think confronted my own family history so just within my genes the acknowledgment that you know basically every man in my family died prematurely of heart disease and in some cases very prematurely in their 40s those two realizations in my mid-30s which also happened to coincide with the birth of my daughter which my first child was a real wake-up call and the realization that you know I needed to figure something out so that I didn't just you know March down the footsteps of what seemed to be my destiny and even then you were in the medical profession right or yeah although I had actually left medicine at this point so after 10 years of medical training including medical school I became sort of disillusioned with medicine and left so at the time that I'm having this realization I'm actually in the world of finance and quite far from medicine what was your biggest fear at the time like if you could take yourself back to that moment like what was the fear that you had yeah that I wouldn't be around to you know be with my grandkids and things of that nature because I think you know prior to my daughter being born I didn't really think I would be the kind of person that would find any joy in having kids and that changed in an instant the second she was born I'm sure there are lots of people who can relate to that probably more so men than women I think because the switch is a little more binary when we have kids and then the thought of you know I'm not going to relive this in 30 years with grandkids I think that was probably the thing that was the most motivating factor well yeah it it needs that kind of incentive to get activated and the reason I asked that question is everyone who's listening or watching I want you to think about what that fear what that challenge is for you because often fear isn't a great motivator to keep going but it's a great place to start and and our health almost starts there sometimes like I remember that I remember feeling like Superman when I was in my early 20s and then all of a sudden having certain health challenges I got into chronic fatigue I had polyps in my throat that had to be lasered out I lost my voice for a few months and that wasn't life-threatening but it was life-altering in the sense that I couldn't communicate in the same way it was different getting my voice back and not feeling like it was as strong or powerful and then having gut issues and inflammation issues and acid issues and all of these things again like they weren't it's not that my life was going to end that year but it's like you start thinking long term and you start thinking about living a unhealthier harder life when is the right time for people to consciously start actually investing in their health and I'm gonna caveat that with what is generally happening and happening in the different Decades of our life so what's happening between 0 to 10 10 to 20 20 to 30 30 to 40 40 to 50 and when is the time when you have a bit more control and ability to shift the trajectory of your health bar any of course major complications or surprises I've never actually been asked it that way but the way you asked it kind of makes me think about different things the aging process in some ways uh there are some aspects of it that are moving in the wrong direction the moment you were born in other words the the moment a fetus comes into this world there are certain aspects of Aging that are only getting worse there are others that are not so you have to imagine now they were talking about different things so I'll give you an example of each something that's getting worse the second you're born is the damage to your arteries so we call this process atherosclerosis this is what leads to heart attacks and strokes heart attack and stroke is the leading cause of death in the United States for both men and women and globally for both men and women but it takes an awfully long time that's why you've never heard of a baby having a heart attack that's why teenagers don't have heart attacks and people in their 20s it's almost unheard of they would have a heart attack but the disease is starting right away and we know this because when we've looked at people who have died prematurely from other causes car accidents homicide suicide and you look at their coronary arteries you already see evidence of disease so we know that this is happening right away and it's simply a matter of time until it reaches a critical level that results in disease and of course everybody's accelerating at a different rate based on many factors genetics smoking high blood pressure metabolic Health all these other things but point being that's something for which you could technically argue it's never too soon to start prevention then there are other things in which we're actually getting better and better and better until we reach a certain point and then we start to demise and an example there might be sort of cognitive capacity so we might have our greatest neuroplasticity in the first few years of life but we're also building on that and if we're in the right environment we're exposed to the right things we're actually getting you know better and better and better here at our fluid intelligence and that probably reaches our Peak sometime in our third decade so that's something where you know you're actually getting better and better and better and then it slowly starts to decline and then there are all sorts of things that are mixtures of these things so for example your physical capacity your muscle mass strength power type 2 muscle fibers cardiorespiratory Fitness all of those things are also increasing in capacity again depending on which of those things we're talking about if it's you know power and explosiveness that probably Peaks early in the third decade if it's strength that Peaks a little bit later Peak cardiorespiratory Fitness again in your 20s and then those things will start to decline what's undoubtedly clear is for you and I we're pretty much in Decline so most people listening to this are in a state of Decline and part of the objective I think ought to be to slow the rate of decline as much as possible but there's another aspect to your question I think is very important right which is like at what point should you start putting effort into this and that's a very difficult question because it encompasses a couple of things when you talk to a person let's do this as a thought experiment you talk to a person the day before they're going to die I mean they would give anything and everything they have for more chance at life despite how high their motivation is there's no Runway left conversely if you went into a high school and talked to a bunch of freshmen and said I've got the program for you that is going to add 15 years to your life I mean they couldn't be less interested right so there's a Sweet Spot somewhere where I almost think people need to go through a little bit of decline kind of like what you described it wasn't life-threatening but you just need to realize that you're fallible to sort of say hmm I can project this movie forward a couple of decades I'm now mature enough to maybe see my parents see my grandparents Aunts Uncles friends People's Health deteriorate and realize that's a bit of a reality check that it's coming for me but yet I still have long enough to bend the Arc of my life and so I think those are the two curves that we're trying to intersect yeah that's a great answer and I and I appreciate that I feel the same way unfortunately always comes through some sort of pain or some sort of reality check or wake-up call that gets us going and it's interesting what you were saying about cognitive function and ability as well there were studies that I read that said that the average age of most successful entrepreneurs is 37 and it's fascinating because we live in a world right now where everyone wants to be a successful entrepreneur by the time they're 21 or 25 and we put these artificial pressures on ourselves when actually there's so much more to it in the genetics versus environment debate what have you what's the latest in that space of like because I think we're not you said you dove into your family's history I think most of us are not fully aware of our family's history even though every time I saw a doctor growing up they'd always ask is there this in your family's history is that that first of all how aware do we need to be of our family's history how important is that for people to figure out and second of all what is that breakdown between genetics and personal environment and career and work you know I think actually family history is such an important thing it's one of these things that we stress to the nth degree with our patients so much so that you know it takes them weeks sometimes to gather the information that we want to know because we want to know and we give them 10 questions for each member of the family so your parents your grandparents your aunts and uncles your siblings like we want to know everything do they have high blood pressure do they have high cholesterol do they take this medication do they take that medication what was their cognitive function like in the last decade of their life you know what type of cancers did they have did they have low bone density you know do they have osteoporosis I mean we really want to understand every detail about it and I think a big part of the reason why is contrary to what maybe people believe a genetic test does not give you that information so if you and I went out and got a genetic test and I don't just mean an all you know over-the-counter genetic test like 23andMe but I'm saying if we went out and got the best whole genome sequence money could buy we spend thousands and thousands of dollars and literally looked at every one of our you know 20 to 30 000 genes we still wouldn't be able to impute from a risk standpoint what you can gather from a very well collected family history and the reason for that is most genes by themselves are not deterministic which really gets to your second question so if most genes are not deterministic they need something in the environment to sort of trigger them furthermore most conditions that we care about are polygenic it's easy to think of the sort of mendelian mono Gene type conditions they get a lot of attention and they're important to be sure but the vast majority of things that people care about cancer heart disease dementia they are not really just related to a single Gene and in many cases we don't even know what the collection of genes look like so genes matter but I think we're going to get the majority of our information by understanding our family history in terms of susceptibility and the environment matters greatly and the extension of that is of course you have great agency over that yeah and what is the best methodology for getting the family history in a complete comprehensive way that's actually it can be hard if members of the family are deceased so for people your age and my age you know our grandparents I mean at least for me my grandparents are long gone so it's you know do your parents really remember and part of it it just comes down to are they being prompted by the right questions now again to be honest in my family history I have very limited understanding of grandparents because you know they just died long enough ago and frankly I don't think my parents were necessarily great historians of this in my case where the bulk of my understanding came from was that my dad came from a very large family you know there were 10 kids two that died young so eight that survived to adulthood and there I was able to elucidate really good information and really understand that there's something very bad going on with respect to heart disease on my mom's side I could also see some issues with her two siblings as well that also gave me a sense of you know what some predispositions might be where can people find those questions or how can they connect with that approach you know that's a good question I I don't we we have a a program that we've developed called early which is like a digital product that is our practice I know that it is within there got it yeah yeah so people like look for early I don't know if you I should know how to do this if you go to like earlymedical.com there's a way to find it okay perfect yeah no I think that that kind of practical step is so needed because one of the biggest things when I was talking to my team and talking to the community about health one of the biggest things that came out is Jay would just stuck on where to start like I don't know where to start I don't there's just too much information out there it's over saturated everyone's telling me to do this and that and it's almost like let's figure out your genetic history like that's a great place to start because that's where we came yeah this program early is divided into 12 modules we think each module would take you about a month to get through and that's the first or second module I think the first module is setting your goals and going through kind of this type of exercise then the second module is okay how do you get your family history how do you take that information and extract what the implications are for you and then go from there what's your take on like full body scans and that kind of testing and how often should it be done because I think again what's happening I was talking to some younger people in our audiences gen Z and it was just like going to see a doctor has become like not even a thought and I could see that in my generation but I remember my parents generation like my mum will still call me up and be like have you seen the dentist every six months like have you been to the doctor every 12 months like you know my mom will still do that with me but I find that that kind of culture is diminishing day by day because of a lack of trust because of a lack of transparency so many different things could just be laziness and complacency what is your take on getting checks which checks how often and I guess the question is how do people know how healthy they are and early is a great plan but from the other point of view it depends on the type of scam so for example there are certain scans that are going to be very helpful at predicting risk from heart disease so for example like coronary calcium scan for the heart or a CT angiogram for the heart those are tests that I don't think are absolutely essential but they can be very helpful if you're trying to further stratify risk you refer to a whole body scan so the best example of a whole body scan that I think provides value is an MRI the reason being is an MRI doesn't have radiation whereas a whole body CT scan or a pet scan would have staggering amounts of radiation we would never want to do that just from a screening perspective but of course not all MRIs are created equal and anytime you're doing a screening test you have to be aware of something called sensitivity and specificity and these are really important parameters we've put out a lot of content on this because I think it's very confusing for people so sensitivity is the capacity of a test to detect something if the something is present so if you're looking at a sensitivity of an MRI scanner for cancer the sensitivity is How likely is this to detect cancer if cancer is present so on the topic of whole body scanners MRIs are very sensitive and again not all MRIs are created equal but I'm assuming we're talking about the best of the best yeah yeah that's good news means if you go into an MRI scanner and you have a cancer the MRI is quite likely to pick it up now it does have some blind spots and every screening test has a blind spot so a blind spot that's worth acknowledging for an MRI is a small calcified breast cancer that's easily going to get missed by an MRI and that's why it's not a substitute for mammography a woman would need to do both the next parameter of of a screening test is the specificity this says How likely is this test to give you a negative result if indeed the condition is not present so it's the mirror opposite of sensitivity here is where those whole body scanners are abysmal they have very low specificity what that translates to in English is they have a lot of false positives I always tell patients look if you're going to go and get these scans and we Advocate that our patients do but they we do it in a much more kind of robust way where it's part of a multiple system of screening tests so that we're covering the bases of everything and trying to attach to the strength and weakness of each study but when it comes to that MRI we say look there's a really good chance you're going to come out of this test and there's going to be some false positives we're going to need to chase down so I always feel bad when people sign up to do these scans and they aren't aware of that because it generates sometimes more stress on the back end yeah yeah I I went through that we had an MRI done and they found like almost like a group or a cluster of things in an area and they're like oh that could be cancer then I had to go and do a um uh endoscopy as well and luckily they found it was nothing but I remember for that week before I was like that's it it's all over here it is like you know I need to whereas I think sometimes if you're told up front hey Jay there's like a 15 chance yeah I didn't I was not talking about that yeah and we want to make sure our patients understand and by the way a subset of our patients probably 10 decide I don't want to have the scan yeah because I don't want to cope with that the stress yeah yeah and it was real I was like all right I'm gonna have to get focused on figuring this out because it sounds bad and I didn't have that layup as you said and it's it's really interesting and and that's what I find so fascinating today right like there's managing your health and then there's the stress and the pain that comes with figuring your health out whether it's the overexposure to too much information whether it's bad information in the past and then we're like oh well just forget it I don't want to do any of it I mean that's what I feel your book does and that's what your work does is trying to help people figure out well let me give you all the information here's how you can know what's good for you and test it for you and write for you one of the things that I love that you talk about is you talk about the need to get rid of you know just focusing on a random diet or following a random diet and actually looking at like eating habits and patterns that work for you and so just putting a little footnote for everyone who's listening the book will walk you through how to make sense of how to know what is right for you what is wrong for you whether you should do something which I think is like the biggest anxiety driver for so many people when it comes to their health when it comes to food I think fasting has become trendy it's become a big thing though everyone's talking about uh you know we hear so much about every single diet in the world there's always a new one that's coming on the surface how have you helped people one-on-one actually discover what's right for them because I found that my eating patterns are very different to the trending habits of how to eat food and even fasting yeah I mean I think the first thing is you you said it's just letting people understand that the less you can pay attention to social media fads and your news feed on Google or whatever the better acknowledge that there is surprisingly little known about the relationship between nutrition and health and people are going to be shocked to hear that because I think most people think the exact opposite most people think that nutrition is the most important pillar of Health and the reality of it is outside of very extreme states that's that's really not true and the very little bit we know about nutrition just frankly speaks to the challenge of scientific inquiry into something as difficult as nutrition to study and the reason for that is you can't study us as humans very well we're very messy subjects so we're not like mice where you know you can put us in a cage and control what we're eating and follow us through the duration of Our Lives it doesn't work that way so when you're trying to make inferences about nutrition in humans you have to rely on poorly controlled studies called epidemiologic studies which are fraught with all sorts of limitations that I talk about in the book or if you're going to control the study you can only do it for a very short period of time there's only a short period of time in which I can control exactly what you're eating so as a result of that we don't know a lot so I always want to start with what do we know well we know that protein is a very important macronutrient there are four macronutrients carbohydrates fats proteins and alcohol people kind of forget alcohol but it's important to understand it's very caloric and so it constitutes a source of energy it's the worst macronutrient but nevertheless it's you know you'd be amazed sometimes people are getting like 15 to 20 of their calories from alcohol if they drink enough so protein is really important and it's not a source of energy the way carbohydrates and fat is but it's a structural macronutrient and so I always start with that and say look rule number one is you have to make sure you're getting enough protein and this is especially true if you're over 50 because if you're over 50 you start to become resistant to the effects of protein that's called anabolic resistance and loss of muscle mass in people over 50 is a significant driver of mortality and a significant driver of a poor quality of life you know if you really start to think about it even if a person is of sound mind and they're not you know suffering from some intractable disease later in life a great source of misery is simply being physically unable to do things after that it really comes down to what do we understand about energy balance well we understand that too much nutrition I call this over nutrition is bad and that the body historically developed lots of tools to store energy because that's what allowed us to evolve the way we did and up until I don't know 100 years ago or so that was a great skill to have it's now uh thwarting Us in an in an environment of too much food so now this ability that we had the superpower basically to store excess energy has become a liability in the United States certainly the vast majority of people probably over 70 of people are overnourished and that's the thing that's driving a lot of their poor health if you're overnourished you have to correct that problem the way to correct that problem is to eat less and there are three strategies to do that one of them is to deliberately go about cutting calories that's called calorie restriction or CR the other one is called dietary restriction that means limit certain things within the diet and if you are restrictive enough that will indirectly also reduce total intake and then the third is fasting or time restricted eating where you create a narrower and narrower window each day in which to eat all of these things can work and all of those things have significant limitations that you as an individual practicing this need to know yeah it was incredible I was looking at the just history of the design of plates and cups randomly I don't even know how I got there how much bigger they're getting just how much bigger they're getting and it was insane for me to think that the way plates are designed the way cups are designed the way anything's designed transforms how we consume and it's fascinating to think that just because of a larger plate size we're now eating larger amounts and we think it's normal in our time where someone else would have think we were feasting I'm sure you still get back to Europe all the time but like look at the difference in portion sizes when you're in you know Italy versus the United States it's comical what a difference it is yeah I remember as a kid coming to the states and obviously when you're a kid everything that's big is better yeah and I remember like pulling over at the gas station and I'd see like this massive like you know jumbo thing to fill your drink up in and like you know forever refills or whatever it is and just like as a kid I was like this is the coolest thing in the world and now you look and you're like wow that's you know there's no need for that so it's it's fascinating also how these cultural shifts and cultural changes have made some of these things harder for us today so you said CR Dr and TR those those are the three that people need to experiment with each of those basically if you are in that overnourished camp you need to employ some combination of crdr and or TR and if you're adequately muscled that's you just you can just focus on that if you're inadequately muscled you have the added challenge of needing to boost protein intake to match strength training while engaging in CR drtrtr yeah but the raw of it is that's it yeah you know the rest of it the alphabet soup of diets is just it's all noise I just encourage people to not fixate on the trend and just think about those different things because you know look each of the alphabet soup diets fits into some form of Dr I mean and that's true whether you're talking carnivore or vegan or everything in between those are just forms of Dr and they can all be effective but you have to be aware of the limitations of each and make sure you're circumventing them yeah absolutely absolutely I I think that one of the things that there's a lot of question marks around as well from the community that they were asking was nutrition which you've beautifully clarified there but nutrition versus supplements yeah and the need for supplements and I think I would love to hear your takes on supplements that are working types of supplements types of ingredients types of chemicals that are making a difference natural supplements too I'd love to hear your thoughts on nootropics because I'm just hearing about New Tropics everywhere right now adaptogens as you just tried as well we've been we've been focusing on adaptogens I'd love to let's talk about your take on great supplements that everyone needs to take not not a brand but I mean like seriously and then you take on nootropics and adaptogens that would be fantastic I mean I definitely do take some supplements I'm always careful to kind of make disclosures so one thing I do supplement I take something called Ag and I'm an investor in ag but I've been taking it long before I invested in it and I know the founder very well I'm very under the hood of exactly how their products are made and sourced and for folks who aren't aware AG is like a green that you you know just mix in with water I drink it every morning they sponsored the podcast and my approach to that is if you buy the thesis that we need to be having x amount of vegetables a day and let's be clear and be transparent I can't guarantee that that is true because we don't know that's another example of something that the epidemiology tells us is true but there are many confounders there but my view is that it's better to err on the side of that's probably true than the than the counter so if you buy the thesis that you need x amount of vegetable a day I actually find it very difficult to do that without exception there are lots of days I can but there are enough days that I can't so my view of a supplement like AG is it's my belt and suspenders approach it's it's basically my way of guaranteeing that by seven o'clock in the morning I've met my needs and then if I have a salad for lunch and dinner as well perfect I went a little overboard but that's better than the reverse to me so that's one and AG specifically talking about that kind of a supplement that's a vegetable focused supplement that's right not all supplements uh that's right specifically focused that's that specific age yeah yeah there's another supplement I take which is a probiotic now no one has been a more vocal critic of the probiotic space than me I have generally viewed it as a space that has demonstrated no efficacy despite all the intentions in the world in the past year I have sort of changed my take so there was a study that came out that looked at a certain type of probiotic and noted that a certain type of bacteria in it would help with the production of something called butyrate and this was actually helping with glucose disposal the results of this study actually were pretty impressive it was a relatively short study a three-month study but it demonstrated in the group that was actually taking this probiotic and this was in a blinded randomized trial that these patients with type 2 diabetes had a significant reduction in in blood glucose even though I don't have type 2 diabetes I sort of subscribe to the idea that everybody benefits from lower blood glucose including those without diabetes so that's a probiotic that I take I don't have any involvement with the company the company is called pendulum but I take their I take their glucose control of probiotic can you walk us through a bit on glucose control because I think that's still an area that for people who are not as well informed that that's an area that I I learned about probably in the last year and a half that has changed what I eat first thing in the morning it's just what I'm eating at different times like to me I was just like oh if I need a boost of something as long as it's a healthy sugar it's fine not only to realize that you know causing spikes in my blood blood glucose level so could you walk us through that a little bit you know glucose is this essential very simple carbohydrate it's kind of the final common pathway of most carbohydrates there are other simple carbohydrates as well fructose being one of them so sugar for example table sugar is a is a molecule of fructose and a molecule of glucose but glucose is the is the most abundant carbohydrate final breakdown product and it's very highly regulated at any point in time you're walking around with you know if you haven't eaten that day somewhere between four and five grams of glucose in your blood maybe say four to six grams of glucose in your blood which is just over a tablespoon or a teaspoon rather so tiny tiny amount but you're using it constantly and therefore your liver is constantly putting more out into your circulation ever so delicately and the balance of that is so fine that if that level were to be just twice as much if you were to go from one teaspoon two teaspoon to two teaspoons that would be consistent with having type 2 diabetes so type 2 diabetes is a condition where an individual can't control the amount of glucose in their blood this is very problematic because glucose when it becomes too high starts sticking to proteins and it starts causing damage all over the place but primarily to small blood vessels so blood vessels in the heart blood vessels in the kidney in the brain if you're in if you're you know in the extremities of the toes that's why people type 2 diabetes are more susceptible to amputations kidney disease heart disease Strokes Alzheimer's disease all of these things anything that compromises blood flow and oxygen so it turns out that even if you don't have type 2 diabetes and that today is just defined by a threshold of average blood glucose above 140 milligrams per deciliter even if you are not in that category it still appears that your mortality goes down the lower your average blood glucose so meaning within the normal range of glucose lower is still better people sometimes say well does that just mean you know you should never eat a food that raises blood glucose no that doesn't necessarily mean that at all what it means is you need to be mindful of matching your glucose consumption to your capacity to dispose of glucose and those are factors that are of course highly impacted by how much you sleep so sleep interruptions in sleep dramatically reduce Your Capacity to put glucose into your muscles which means glucose levels get higher it also has to do significantly with how much you exercise and how much muscle mass you have so people can have completely different tolerances for glucose and I think I write quite a bit about this which is you know basically trying to understand your your glucose tolerance level comes down to matching it with your insulin sensitivity muscle mass activity levels sleep stress Etc absolutely thank you so much sorry and I got you off from moving away so just to go back to this other point quickly so there are lots of other supplements that I think can be really valuable I think B vitamins are very important especially methylated B vitamins vitamin D is very important many people I think don't have sufficient levels of vitamin D I think the data on vitamin D we could do an entire podcast on that the clinical trials looking at vitamin D levels are really poorly done clinical trials and so I think if a person looks out at the literature and the literature says there's no evidence that vitamin D really helps I would argue pretty strongly that those trials haven't asked the right question and weren't designed correctly so my view is it's better to probably err on the side of caution and make sure your vitamin D is probably somewhere between about 40 and 60 and if you're not achieving that through natural exposure to sunlight which many people are not then you're probably better off supplementing there are a couple of other supplements I really believe in and I think magnesium is a very important one and I think you have to be thoughtful about the form in which you take magnesium so you can take magnesium in a slow absorbing form or a fast absorbing form that's poorly absorbed technically and I think we need both right so I think that I'm like a poorly absorbed magnesium would be like a citrate glycinate or oxide and those actually really help with bowel regularity So for anybody who's a little bit constipated or just you know kind of needs to be a little bit more regular we always want to have in anywhere from two to five hundred milligrams of one of those forms conversely I think virtually everybody also benefits from a slow absorbing form of magnesium the brand that I like is called slow mag again I don't have any affiliation with any of these companies unless I'm disclosing it as I did with ag that actually you know so most people if they notice oh I have a little bit of cramping sometimes or you know I'm getting little palpitations called PVCs sometimes those get a lot better with magnesium supplementation so so I think most people benefit from that there's another type of magnesium that I'm a fan of called magnesium L3 and 8 which is magnesium paired to a transporter that gets the Magnesium into the brain I think there's reasonable evidence I wouldn't say it's incredible but I think it's quite good that magnesium L3 and 8 is beneficial to the brain and and might even have some capacity to reduce the risk of dementia before bed I tend to rely on ashwagandha which I believe you said is in there so I take a big dose of ashwagandha and Glycine and again I take that magnesium L3 and 8 and those are kind of things that I think help with reducing cortisol and making it a little easier to sleep then the final supplement that I do think most people benefit from and there are probably many others but I'm just sort of going through a few that I can think of would be fish oil so most people probably don't consume enough Marine fat to get what I think are ideal amounts of EPA and DHA which are two very special types of fats called omega-3 fatty acids and EPA and DHA I think the balance of evidence is is quite strong that they're both beneficial to the heart and the Brain EPA probably a little bit more for the heart DHA probably a little bit more for the brain I take a brand that I've had tested because you always want to be careful about contaminants here and it's it's made by a company called Carlson's again I have no affiliation with them but I take their EPA and DHA um daily as well that's a fantastic summary for anyone who's who's looking I take all those things yeah you know I think that's a brilliant summary and I I really hope everyone is listening and watching you know get those checks and tests done and and grab those supplements because again I like what you're saying that it's all about airing on the side of caution right it's it's almost like protecting yourself being safe rather than assuming that a you get this or B it doesn't really matter you know is it that we used to find these supplements in other forms before or as humans if we always ignored this and now we've suddenly figured it out or has our lifestyle just got so stressful and intense that we're needing more of all of this to support the pace at which we're moving yeah it's a great question I do think that the supplement world is such a slippery dirty world that I always want to throw out a disclaimer which is when I talk about these things I'm also very diligent about the brands that I buy so again I have no affiliation with any of these entities but having looked at third party testing I find the brand gero j-a-r-r-o-w the the brand pure encapsulations to be two of the most reputable companies out there so I'm basically always going to try to buy from them if I can even if I'm paying a little bit of a premium your question is a very good one and I don't know how much you've paid attention to kind of the field of regenerative agriculture but it's a topic that interests me quite a bit and The more I've read about it um The more I've come to realize that I actually think part of the problem is our food today is far less nutrient dense than it once was and so I do think that many of us don't get the same quantity and density of nutrients today that we did for the same caloric intake say 50 years ago and the proponents of regenerative agriculture would argue that a big part of that has to do with soil health so as the health of the soil has deteriorated with more tillage more fertilizers less crop rotation all of these things the net result of that is the plants themselves are less healthy so when you're eating a plant you're getting less nutrient density and of course when you're eating meat if you're an omnivore the meat is all also less healthy and less nutrient dense because it's eating a less nutrient dense plant which is growing in a less nutrient dense soil and so the old adage that you know it's hard to be healthier than the animal you eat which can't be much healthier than the plant it eats which can't be much healthier than the soil it grows in brings this whole thing full circle and so I suspect that that plays a pretty significant role in it coupled with the changes in our lifestyle right so many of us would have got sufficient vitamin D for example in the past because we would have been outside more and we would have been active more and you know today we aren't as one example are you seeing the rise of more regenerative farming and places to buy regenerative vegetables or yeah I mean is that even a thing yeah no it absolutely is and and there there are there are some great places uh you know certainly one of my sincere hopes is that you know we see we see a greater and greater movement to scale this because I I do think Regen of Agriculture is not only what I think of as one of the most important ways in which we can improve human health through nutrition but but for folks who are also concerned with with climate change and the effects of anthropogenic CO2 regenerative agriculture probably has more potential to attenuate that than anything else inclusive of electrifying the entire Transportation grid and that's a pretty bold statement it is it's very important that's what I want to dive into it too like what gives you confidence to make that bone statement like what have you seen that has given you that conviction it really comes down to understanding the capacity for plants to fixate carbon I'm sure everybody understands you know the basics of how how CO2 works right so why why is there a concern with the combustion of fossil fuels because when you're combusting a fossil fuel whether it be cold or natural gas you're taking carbon that was sequestered billions of years ago in the form of fossilized you know know organic matter and you're now liberating that carbon dioxide out so how do we get carbon dioxide back in the system well plants do that so plants have a capacity to do something that no animal does which is they fixate carbon so they fixing carbon literally is just the chemical process of taking a carbon out of the out of CO2 and attaching it to another hydrocarbon the way that regenerative agriculture works is by storing more and more CO2 and carbon specifically in the soil so right now the way conventional agriculture works when you're constantly tilling the soil you're leaching carbon out of the soil and so you know when you look at the mathematical models that look at how much carbon could be brought back into the ground and sequestered I.E brought out of the atmosphere it's more significant than the carbon that's being put out through the combustion of fossil fuels the reason I'm particularly excited about that is you're basically getting two ends for the price of one right so you're reducing atmospheric CO2 but doing so in a manner that's also very positive for our health because in doing that you're increasing the soil health and by extension then the nutrient density of plants and ultimately animals and ourselves what's your take on regenerative agriculture versus lab produced vegetables I have yet to see any evidence that laboratory produced meats and vegetables can be done really well at scale or that they are particularly certainly any more viable in terms of of the nutrient density I think in part it comes down to the complexity of soil there's a great book I would recommend for people who want to go really deep on this I believe the book is called what your food ate and it's it's a wonderful book it's a it's a bit of a deep dive it's a nerdy book it's not Light reading and they go into incredible detail about David Montgomery yes and there's another once you get under the hood of how complex soil is so for example many people talk about the human gut biome and uh you know we talked to minutes ago about probiotics right well the human gut biome is really complicated and we haven't figured out a way to perfectly model it I mean maybe we're just getting to the point where we can figure out if we add a little bit more of one bacteria can it make a difference in in the direction that this thing goes well it turns out that soil is probably even more biodiverse and complicated than the bacteria in our gut and so again I just think it's very difficult for us to sort of play super farmer and think that we can kind of replicate what Nature has figured out for you know literally a billion years well see so yeah so your understanding is actually that we don't know enough about the complexity of the soil which is actually what is impacting the quality of the vegetable or hence then all the way up all the way up the chain hence even if we can produce a vegetable or me in a lab it won't have that same that's my take on it which says nothing about it which says nothing by the way about the scale factor I think at the end of the day scale matters like I mean food I I think it's safe to say agriculture is the second largest industry in the world just in terms of like the magnitude of what it takes you have to have solutions that work broadly and and by the way I think that's still there are certainly proponents of regenerative AG who say it can be scaled but I think that's an open question still regenerative agriculture right can it be scaled to meet the needs of the entire world yeah what are the challenges with scaling that it's a totally different infrastructure truthfully right it's not going to rely on as much automation so for example like you're not going to be able to rely you know so so one of the Hallmarks of regenerative AG is you're not using fertilizer uh you're not so you're not using the nitrogen of a fertilizer you're actually using the nitrogen of the animals another one is you're not using pesticides so you're crop rotating instead of using pesticides and allowing you know the crops themselves to generate resistance uh by cycling them and not letting the pests get used to the same crop not to you know belabor the point but all of a sudden the industry that is now dominated by the the Pioneers the cargills the monsantos of the world it's going to have to look very different so I think that's a big challenge is going for from Big to little and then scaling little if that makes sense where are the places like if people are fascinated to have you been out to any regenerative agriculture Farms or anything yeah yeah yeah there's there's one outside of Austin there's actually one here in California so there's not many there's like I mean there's so the one out in California is called there's a documentary made about it called I think the documentary was called biggest little farm that's not too far from here by the way and uh my kids were obsessed with this so we like watched this documentary like I don't know 15 times but you'll get a sense of what it looks like but yes no I mean you I think everybody can find regenerative farms near them so really it's just a question of helping Farmers understand why ultimately it is in their best interest to do this so economically it makes more sense but look it's going to require the government completely changing incentive structures and changing the way they subsidize certain crops today it's a big shift yeah what's your take on people trying to create Little Farms in their home like the they're like mini growing yeah I mean look I think it's wonderful I think if you can grow your own vegetables I mean we have a vegetable garden and there's no question that the the the vegetables we grow taste infinitely better than anything we're going to buy at the grocery store and how do you take care of the soil in in your area you're saying because it's untouched it naturally has yeah I mean we use we compost our own stuff so but it's you know look it it's not even big enough to completely feed us right so you know it's it's there's work that goes into this and I and I have friends that that do have the time and effort to at least you know support themselves fully that's beautiful yeah yeah I love that you know my wife's really my wife's really big on that she wants to build a little vegetable garden on the back right now in in the same way because that's one of her core beliefs as well so just this past weekend I was I had to put all this chicken wire around the fence where our garden is because these squirrels are figuring out a way to get under the fence and they're like eating all the tomatoes and the peppers and stuff and it's like my son who's eight this is his project and it just drives him nuts when the squirrels are getting them so what what a great age to like get connected so it's so great yeah it's the land into the soil into growing that's so beautiful I love that yeah we've had to go for problem for for years here and it's like it's always ruining the lawn and I'm like well if I plant vegetables here those vegetables are gonna be gone yeah you have to be you have to be smart about it yeah yeah incredible uh I I want to make sure that everyone knows the book dives into cancer Alzheimer's uh we talked about we're going to dive into exercise in a second we talked about diet you know eating less eating patterns I want to make sure because I don't want to either repeat things that are already in the book or repeat things you've talked about in other interviews and so I just want everyone who's listening to know that that you know it dives into multiple key diseases that we're all struggling with today and the biggest challenges one thing I wanted to talk to you about which I think you really wonderfully highlighted was this challenge between physical health and emotional health and you talk about the need for prioritizing emotional health as well and I've found that so much of my subtle emotional health was so based on physical health so what I mean by that is I found at one point in doing all of my checks and tests that and by the way I was doing I was functioning it like a really optimal level I was just feeling tired and when we did my test we found that my vitamin D was at a 10. this was around two three years ago and I realized the majority of the challenges I was having was because I was sleeping we rented a home during covid we moved from our apartment and when we've rented this space I never slept well in that space because it was just the most like noisy loud area because there were it was it was in the middle of uh too many animals too many things at night like going through the floorboards like it was an old old space and so there was like I was waking up multiple times which I don't usually go through and so I started to find that a lot of my emotional challenges whether it's fatigue irritability um you know stress because of that environment was causing emotional challenges but it was actually all coming from a physical space if that makes sense for sure and and I think so often these days I find a lot of us are just trying to solve everything in our mind rather than recognizing that often it's a chemical it's biological it's it's physical so I want to just point that out to people because I think a lot of us like I could have done anything to change I was working out I was trying to sleep right I was doing everything I possibly could but because my vitamin D was at a level 10 there's not much you can do and instead of apart from taking Vitamin D supplements how where are you saying this relationship where are you seeing this relationship between emotional health and physical health well they're absolutely linked and you know I think that one of the things that I've observed you know my therapists will always ask me at the beginning of a session is how are you doing physically so are you in pain right is you know is your shoulder bugging you is your back bugging you do you have like an ulcer in your mouth or something like like literally something like that how are you rested and how much stress are you under and the reason I think is those things exacerbate vulnerabilities that we have on the emotional side on the mental side so if you take an individual in two parallel same individual and two parallel universes but in one situation they have lots of issues going on physically right so they're not well rested their vitamin D is low they're in pain and you have another individual for which everything is physically uh firing on all cylinders and you present them with the same emotional distress you're going to see a completely different response that's a big part of why I think it does matter to keep your physical health in order to optimize your emotional health but I would also argue that you could still have your physical health in perfect order and you know not becoming close to addressing your emotional health when you use the term emotional health what does that constitute for you I try to distinguish it from mental health right I think mental health is a subset of emotional health but it's the perhaps the more medicalized piece of it so in in medicine we use something called the DSM the diagnostic and statistical manual I think we're on version five and that's the one that codifies psychiatric illnesses right everything from depression anxiety different personality disorders and all sorts of things like that and those things clearly matter but I'm talking about something that is applicable to everyone whereas those things might only be applicable to people who would meet diagnostic criteria so emotional health in the sense the way I think about it kind of encompasses your relationships with other people your sense of purpose fulfillment Happiness joy spontaneity all of these things that every human should be thinking about because every human is a part of those things in my case you know so so the book is written basically at 17 chapters 16 of the chapters are me you know writing about it as the doctor yeah the scientist and then the last chapter which is about emotional health is me actually just writing about my personal experience and my own well transformation I think would be an understatement you know I think that the most important lesson for me in the past decade has been that all the health stuff that's that makes up most of that book how do you reduce your odds of getting cancer how do you reduce your odds of getting heart disease Alzheimer's disease how do you make sure your muscles work better in the last decade of you know all those things they're very important but if you're miserable none of it matters right if your relationships suck none of it matters and I can't state that enough but I I couldn't have understood that a decade ago you know I had to personally experience things going really wrong I had to nearly lose everything to realize I've really missed the plot here and if I don't get this stuff addressed then the rest of this outliving doesn't mean anything what was the wake-up call for you or what was the uh I mean I think if you know it was essentially almost losing my family right it was just being so so selfish and so such an awful person that you know I I finally woke up and realized how much I was hurting everybody around me and I was confronted with that and confronted with the reality that I had no choice but to go away and get help to to sort of address my own reasons for why my coping mechanisms were so negative what made you so selfish and awful like where did that come from well I mean again at the time I had no clue but but also at the time I don't think I was even privy to understanding what um what I was doing but but obviously as I as I talk about in the chapter when I what I basically learned is I think a lot of my adaptations had to do with you know certain things in my childhood some of which were you know I describe as kind of Big T trauma and some of which are frankly just little tea trauma but but collectively they just produced a response an adaptation I talk about this sort of model of trauma where wounded children become adaptive children and adaptive children are there to protect the wounded children and I think that's a remarkable trait of us as humans right we are very resilient the problem is that a lot of those adaptations become maladaptive in adult life and I think that's really what I was dealing with was so many of my adaptations you know for example control Drive Perfection anger all of those things served me quite well as a child but as a husband and as a father they were not serving me well anymore and all of the good that came from those adaptations for example a strong work ethic a desire to to to do good was was more being done for the wrong reasons it was I'll show them I will you know I will matter my my self-esteem will be based on performance Etc and I think all of that had to be turned on its head for me that was sort of my journey was learning how to undo all of the maladaptive behaviors to try to keep the good parts of the adaptation and then shed the the harmful ones why do you think it takes us thank you for sharing by the way and I know you're going to more depth in the book and I I find this fascinating and I think people I'm so happy that you address it because I think people find it especially fascinating from coming from you because often they're just seen as such separate things and separate Pursuits but for you to unify in them is is really really interesting why do you think it takes so many of us so long to address the very root cause of so much of our problems and you partly covered it there that some of these things become superpowers in the material world like they're phenomenal you know manipulating the outside world through control and uh perfectionism Etc but then in the inner world in the the family tends to suffer from that why does it take us so long to Look Backwards almost to look forwards in both our genetic background and our also genetic trauma in that sense I don't think we want to uncover painful things unless the pain that we're confronting is greater than the pain we're going to encounter by doing so that's probably my simplest thought as to why I just think that like how many people without ever having experienced dental pain would go to the dentist right like you do as a kid because you're sort of told but but when I think about now like why do I put so much effort into taking care of my teeth it's because I've learned how miserable it is when um when I don't I think until you experience enough discomfort in the present and in my case that came through the circumstances I write about the pain of turning around and going back and exploring what happened and why and and then embarking on the corrective steps and learning a whole new language and a whole new set of skills I mean there's we in chemistry we call that the activation energy of a chemical reaction right so you know every chemical reaction has to overcome sort of some sort of activation energy and the higher that activation energy the less likely that reaction is to take place so enzymes which people have heard what's an enzyme do an enzyme or a catalyst will make that reaction more likely it lowers that barrier to Activation so I think what we need in our life are catalysts we need something and unfortunately I think sometimes it often has to be painful a loss to to force us to do that I make a point when I showed up in the first rehab place I went to there was this there's a woman that I met there who could sort of see from the look on my face that I wasn't happy to be there she just said to me in in a manner that was just so perfect she said hey nobody shows up here on a winning streak yeah this is just 100 True how how did you help the people around you that you cared about be patient as you went through your own Journey because I feel like it's really interesting when we're trying to solve our own wounds and pain it's already so hard but because we've taken on responsibilities or commitments whether that be in a marriage or as a parent or even as a CEO or a boss or whatever it may be it's like all of a sudden you have so many other commitments that you had taken on even before you realized you had to work on yourself did you find yourself helping them while you helped yourself to be around and be supportive as opposed to like tap out and say you know what we don't want to be around because I think we often look at like how are people helping us in our time of struggle but sometimes it's like we already committed to them and then we realized that does that make any sense it makes a ton of sense and I I will tell you I think it just speaks to how fortunate I am and perhaps why I feel I have an obligation to talk about it which is I just think I was really lucky and that the people around me stood by me and let me go through this and and gave me the chance to do it and stood by me because I don't I don't think many people would have I really you know I've said this to my wife many times I describe her as like you know sort of Hall of Fame wife who didn't really need to stick by me I think she had enough reasons to leave and take my kids away and just say to hell with that guy and that she didn't I will forever pay that forward and I think the same is true of people that I worked with who knew I was struggling I think deep down believed that I was not a bad person I was a good person who did very bad things and that I deserved another chance I wish I could say I was supporting them on that Journey but I don't think I was I think I was just reeling in pain and lucky that they stood by me well thank you for sharing that that's that really hit me there's you know don't expect people to catch you when you're falling but if they stand by you never let them leave you aside because I think most of us could probably the fortunate ones attest to that I would say that about my wife too I'd say that about my parents I'd say that about the people that I'm surrounded by that sometimes I haven't had the capacity to help them as I help myself even though I intend to but the problem sometimes is we do the Other Extreme where we demand them to help us that's the balance it's like the gratitude that you're displaying right now is is actually like the right I think a wonderful balance because we do either or we either go I'm going to solve this myself and I don't need anyone or I want my family to solve my problems for me interesting yeah like we live in one of those extremes and you're actually saying well I had to help myself I'd admit I didn't have the capacity to help them at the time but now I'm just grateful and I'm humbled by the fact that they stayed here like there's some there's some beauty to that and uh that that really resonates it's probably four years after one of the events that I write about in this book which was when my son almost died I was talking to Esther perel and I was just saying I don't think I could ever forgive myself for what I did and she said that's okay I think it's okay that you remember this for the rest of your life I think there's a degree of humility you need to carry with you forever and I think that was really wise thing to say right like I think it would have been easy to have said no no no no you should just forget about this and move on but she's like no you should remember this forever this is the humility you need to remember and and she described it in a very eloquent way which was you need to understand that there's a monster in you and he's never going to go away I'm confident you will keep him in the corner for the rest of his life but don't ever take an eye off him yeah and don't ever think that just because you're better now you're better for life this is a constant process yeah and and remembering that there's a monster in you but you are not that monster that's right yeah he's over in the corner and you have the you are the one in charge of whether he stays in that corner yeah it reminds me I remember in my early experience of living as a monk I said to one of my monk teachers I was I said I just feel like I'll never overcome my ego like it just is too big like there's there's too much to deal with and it's not that it's coming out in an externally gross way that it's manifesting but I I can I know it's there you know we've trained in self-awareness and and I can see it and he said to me yeah it's always going to be there because it's not going anywhere and he said it will always act as your anchor and ground you and humble you even when you saw to new heights or whatever else your life brings to you that you knowing that it's there is actually what will help you right you know stay grounded which is such a beautiful reminder as opposed to like ego death and we're gonna crush it in it's interesting with the health too right with emotional health and physical health that from what you said the first thing you said today was you know there are certain things from the moment you're born that that's it it's already going in the wrong direction and we often think of like how do I end this so how do I start this how do I finish this and it's like well most things are just in motion they're not beginning or ending they're just yeah already happening and as you said earlier we're trying to slow it down or we're trying to be aware of it or we're we're trying to monitor it when you were speaking about your family there and you're talking about that emotional well-being there was something that came to mind there were these two beautiful words you used which one of them is used a lot but one of them not so much but you talked about joy and spontaneity and I love the word spontaneity I think it's not used enough when we talk about emotional health Joy is used but the challenge I find today when I'm talking to people is that we're so Overexposed to whether it's whether chemically we're talking about dopamine or whether we're just talking about like like fun pleasure instant gratification which we've talked about for such a long time that everything feels boring almost it's it's hard for people to get to a state of Joy or spontaneity I find that a lot of people have a sense of like what what's there to look forward to or like oh nothing's that great it's okay like you know whereas before and now it's like it feels like you've got to up the results so hard and the problem is even when you up it like you're thinking that happiness is in Europe on that yacht right and in fact even if you got there it won't actually even live up to that experience that you put in your mind right because it was never about the physical manifestation of it it was it was the idea that you've over exposed yourself to so much pleasure that now even the highest Pleasures don't satisfy or suffice how do we work on that like what is the health and emotional version of approaching that problem I wish I knew I mean and I think you're addressing one of the most important questions and this is something I I really struggle with because you know for me I and I was just talking about this with someone earlier today I think about the next decade of my life this amazing time where I get to be with my kids the most because you know as you're probably aware the the data are pretty clear that once your kids leave for college the amount of time you will get to spend with them is is quite small I think it works out to basically you have a total of 19 years with your kids 18 of which occur until they leave for college and then one year is the sum total of time you will spend with your kids the rest of your life on average so I look at that and I think I regret the time I've wasted so far right but so so that's the stuff I talk about and now I'm here in the future I think wow the greatest source of Joy I really experience is with my family that to me is what spontaneity is Right spontaneity for me is an important the reason I brought it up is I'm a very rigid person by Nature like part of control for me is rigidity deviating from my plan is a very hard thing to do but I also realize it's a very important thing to do so like I'm the kind of guy who makes lists on weekends me too right like there's just ever like there's a list of 12 things that have to be done on Saturday and eight things that have to be done on Sunday and you can imagine that that that rigidity takes any spontaneity out of life and one of the great things I've learned is how to screw the list sometimes the other day when I went to get you know had to go to Home Depot to get all the chicken wire to do the thing like that wasn't on the list that day but I could see that my son was upset that the squirrels were eating his tomatoes and I was like you know what I'm I'm supposed to be doing X Y and Z let's go to Home Depot yeah I think interestingly anyone who who does that which I'm sure is everybody listening to this at some point can experience that those are probably the things that bring more joy than the yacht in Ibiza it doesn't mean that you should never go on the yacht in Ibiza yeah I think it just means that don't dismiss the stuff that's right in front of you and again for most people I really do believe connection is that thing like just having intimate connection with friends and family probably provides more of that than any of these other kind of material things yeah and and I think what you're saying is actually true and I want to clarify that point too that I actually think that when you are not missing the simple things that are right in front of you then when the big material thing is right in front of you you won't miss that either that's that's the point I believe like I think that if someone is grateful for where they're at and what they see and what they experience and are able to immerse themselves in it then the same happens on vacation the same happens on the yard as as our thought experiment like the idea is is that the ability to experience a flower as a Thor experiment in the most immersive way allows you to experience a garden which allows you to experience a forest which allows you know it's it's that you can't really fully experience the forest if you didn't know how to experience a leaf that idea of that much immerse and I've and I've personally experienced both the presence and absence of those experiences where sometimes I'm walking up and down here or doing my morning hike and you completely Miss The View because you're on your phone or even if your phone's not there you're thinking about something and then and then second you look up and you're oh wait a minute like this was right there and so I think we all experience presence and absence and I found that beautiful we think beautiful things will make us more presence but actually we'll be absent even in beautiful things if they're not present for the small things and I've seen that again and again and again uh and in your example and I'm just I'm only picking at this because I think there's so much lived experience in what you're saying and and the scientific backbone helps too it's like how have you also not end up because it sounds like your kids and your family is just so important to you which is beautiful and I think that's true for so many people but again I find that a lot of the people that I'm talking to are living at The Other Extreme where they're like Jay I am so giving in to everything my kids want to do what my family wants to do that I don't even have any of my own habits and disciplines right like for you going to get chicken wire was a spontaneous moment of love for your son who's worried about this project that he loves whereas for some people all they're living in is not spontaneity but in urgency and and then they're not getting I was speaking to a friend the other day and they were telling me Jay I wake up at 6am but what happened and then I was kind of walking through their schedule with them for the day and helping them map habits and they were like I don't know what and I was like well when do you start cooking lunch for example that they as part of their day they have to do and they were like 12 and I was like so what happens between 6am and 12 noon they're like I don't know I was like what do you mean like you know like that's six hours of time like where does it go and then they were like emails phone calls random people calls random things happen it's all like I'm like wow you're waking up pretty early which is amazing but now all of that six hours is just lost in kind of moving how have you found that balance between like I love my children I want to be there but I also need to do everything I say in this book which takes time and energy I don't want to necessarily use myself as an example because I also realize like I have some really good things going for me which is I have like an amazing spouse and I have an amazing team and all of these things but what everyone around me has figured out is if you want to get the best out of me as a husband as a father as a friend as a boss as a colleague whatever it is if you want the best version of Peter he also so has to be well rested he has to be eating well he has to be exercising he has to be doing the the things that he has to do every day for his mental health I am actually quite structured when it comes to that stuff so I'm very routined with how I do things so I do not take a single call or meeting with very rare exceptions once a month there's an exception to this rule before 11AM I am scheduled without a break from 11 to 5 every single day so I have six hours of pure schedule that I consider that not my time it's my patient's time that's my team's time that's me giving 30 hours a week to everybody I get up at about six from six to eleven is really sacred time so six to seven is just coffee with my wife and playing with the kids so my daughter of course knows she's still sleeping but the boys were playing board games doing puzzles having coffee doing whatever from seven to eight is work just get the emails done uh read whatever I need to read et cetera Etc from 8 to 11 is Hobby plus exercise so every day I'm either in the simulator driving or shooting my bow and arrow and then I'm actually exercising from five till about seven is family time so I'm usually cooking dinner playing with the kids going to you know Jiu Jitsu whatever it is and then seven till ten is some combination of family time plus work and that's where there's has to be some flexibility like how much more work do I need to do and the price I pay for that is I have to work on weekends too right why because like I'm forcing the time to be spread out and so that means like yeah there's just you know there's other things I'm going to have to make sacrifices around but I guess my point of that is you have to kind of try to take hold of the schedule a little bit and sort of say like there are certain things that are non-negotiable so not exercising is a non-negotiable not having some time with my family is a non-negotiable I rarely travel anymore I used to travel 20 days a month I travel two to three days a month now just very deliberate and conscious decisions about how I want to spend my time and the importance of you know taking care of my body in an effort to take care of everything else absolutely no it's and I definitely I agree I don't think we want to use ourselves as examples or you know as as the way to do it because everyone's so personal I think it's just useful understanding that that structure is needed for that spontaneity what might be more helpful for people to understand how I communicate this with my wife so my wife is that person who will put everybody ahead of herself so what I have to help my wife do is realize hey like you need to go for a run too because that matters a lot to you and you need to go out with your friends and have drinks once every two weeks because that matters or you need to go and get a mani pedi with your daughter and actually relax I'll pitch in and do this other thing because I really feel strongly about you doing that and that's not something I would have done before before I would have just sort of said hey it's awesome you're doing everything great yeah yeah so I think as a spouse you want to sort of really understand that as true as that is for me it's just as true for her I think that's the key thing in a and I we don't have kids but I can definitely say on a relationship level it's like just because your partner can do something and is doing something doesn't mean that you should just accept that as reality for the rest of time and I see that that's one of the biggest challenges in relationships is people feel like their role is assumed because of what they've done in the past but no one checked with them as to whether they were okay continuing to do it or whether they felt good doing it and we think well they should tell us if they don't like it they would tell us like I would tell them but often you find that someone so ingrained in playing a role that they've even forgotten that they have needs or or who they could be or can be or they feel this over bearing burden or urgency in their role that they just can't disconnect from it so yeah I think that's a great going to highlight Peter I mean there's so many I really do want to talk to you if you still have the time I really do want to talk to you about cancer and maybe Alzheimer's as well because we went on a different direction which I wanted to go into and which I loved but I want to talk to you about cancer just because I lost I've lost three people in my life to cancer I lost my uncle who was my mother's brother when I was around gosh maybe I was around maybe just about to be 18 or something like that he had throat cancer and it was tough to see him go through that it was the first time someone in my direct Circle I'd kind of witnessed the Journey of someone like struggling going through pain and and then you know dying at a young age he was like 57 years old and then I saw my one of my probably my closest friend uh who I lived as a monk with and he was still a monk when he passed away and he had colon cancer he was like my age like he died two years ago now so like that it was a bit a couple years older so like 35 around around there about I believe some of that was genetic which we found out afterwards or like during the process and he went through tons of cycles of chemo and like he tried everything like that guy had spirit and resilience and and everything in it you know it was tough and then I lost my spiritual mentor to brain cancer um in the same time frame during the year of kovitz I also missed both of these people's funerals because I couldn't go back to London because you couldn't fly at the time so anyway all of that to say I've just lost so many people to cancer and I think that's just not uncommon which is even worse in one sense like I think everyone who's listening is like yeah Jamie too and so I think it's so important to talk about because I don't know was it one in three one and two is it I don't know what what the stats are but yeah because it's so common because it's so normal now and just someone having cancer but at the same time it's the most painful news in the world because you kind of feel like you know where it's going to go what have we seen as proven ways of preventing and confronting cancer um both holistic and you know traditional medicine you know the way I sort of think about it is there are three things to be thinking about three three categories so the first as you said is what steps can you take to prevent cancer the second question is if you get cancer how can you catch it as early as possible one thing we really do know is that if you treat a cancer earlier your chances of beating it go up and the longer you wait to treat it meaning the later you catch it the worse your odds and then the third question is if you do find cancer what are the ideal treatment strategies let's start with the first question and this is the least satisfying because we don't know a whole lot about what's causing cancer so we know two things for sure we know that smoking is a Big Driver of cancer and we know that obesity is a Big Driver of cancer now obesity is a bit of a misleading term because it's just kind of a overly simplistic way to think about what's actually happening the data say obesity but really what it means is insulin resistance and inflammation those are two Hallmarks of obesity that are present in 70 80 percent of cases of obesity and if you look at the data more closely that's what's actually driving cancer so it's not actually how much fat you have on your body it's more how much fat is in certain parts of your body that are metabolically problematic But after those two things smoking and instead of obesity I just prefer to say poor metabolic Health we have some one-off examples we know that there are certain types of exposures pesticide you know certain types of pesticides for example certain type of toxins but those don't account for the significant majority of them so for many people cancer is still a mystery in other words whatever it caused whatever caused the initiation of the genetic mutations that ultimately led to a cancer that the body was not able to on its own remedy is still a bit of a black box and some very prominent cancer biologists actually just argue that it's bad luck in other words it's a stochastic process so our genes are constantly replicating but when mistakes are made mutations occur and some of these mutations Drive cancer and there's broadly speaking two types of mutations there are mutations in tumor suppressor genes so these are mutations in genes that are there to stop cancers when cancers appear and then there are mutations in what are called oncogenes These are genes that propagate cancer so mutations in any of these things can actually lead to cancer so once you sort of accept that you're going to do everything in your power to not get cancer which is to say you're not going to smoke you're going to be as metabolically healthy as possible you're going to exercise sleep do all those things right the next most important thing is thinking about your strategy for cancer screening you know this is where I probably differ significantly from the mainstream you know establishment view which is is actually kind of you know know not that aggressive on cancer screening I would argue that we have to be very aggressive on cancer screening provided we can get our minds around the problem we discussed a little while ago which is we understand that there's going to be the harder you look for something the more likely you are to find something that isn't relevant but if you understand that going in and you're willing to accept that risk and evaluate each finding in a thoughtful way I think that for most people psychologically and physically the benefit is is a net positive one and so that means looking at things that are for example with a colonoscopy doing it earlier and more frequently than is the standard recommendation the standard recommendation is not to begin till you're 45. we would recommend that everybody even without a family history begin at least five years before that it also means repeating colonoscopies more frequently especially in the finding of certain types of polyps whole body screening you talked about with certain types of MRIs we also use something called the liquid biopsy so it's a blood test that looks for really really small fragments of DNA in the blood and can identify the presence of cancer and the tissue of origin now again none of these tests are perfect so each of these tests have things that they're going to miss but the idea is that the more you're layering these tests the better your odds are finding something earlier and then the final point is okay well what are the strategies you know if should you have cancer and this is where I think we just have a little bit more promise now than we did a decade ago so a decade ago because this is the first time I did this analysis in the previous 50 years so from you know 60 years ago until 10 years ago the overall survival Improvement in cancer was about three percent wow it is abysmal but in the past 10 years it's been about another eight percent and while that doesn't sound remarkable and the implication of that is is half the people who are diagnosed with cancer today will still die from cancer it's the biologic insights and the trajectory that we're on right now that gives me much more hope and that is primarily based on a couple of things the first is the field of Immunology has really taken off the tools that we have to harness the immune system to attack cancer have become so dramatic immunotherapy right that's right that it really is I think within the next decade which I know seems like an infinite amount of time for someone who's got cancer right now we're really seeing changes that I think are going to allow immunotherapies to go from the niche place that they occupy in only working for certain types of cancers like melanoma and kidney cancer to being able to go after the Holy Grail of cancers which are what we call the solid organ epithelial tumors rest pancreatic colon lung these are the big cancers that do the majority of the killing 50 percent of cancer deaths are just five cancers lung colon breast prostate pancreatic that's more than 50 percent of all cancer deaths until you have a solution for those we're not we don't have a solution for cancer and I do believe that we are really moving in that direction we've touched on this point a few times of almost the stress about stress for health and and that's a really interesting way of thinking about it it's like the stress of oh I need to work out today the stress of I need to have my supplements to the stress of I can't sleep why am I not sleeping right like we stress about the things that are good for us how have you helped your patients have you coached them through that how do you guide people through that because I think a lot of people go well then I'm just not going to do anything because at least then I'm not stressed I don't think that's the wisdom in what you're saying I don't think you're saying well yeah it's better not to have any stress at all how do you help people to engage and you know use that stress in a healthy way or how do you guide patients through that stress I mean I think every patient's different and I think you have to sort of get to know the person a little bit and figure out what what's the underlying issue so I do think that there are a lot of people who frankly self-sabotage going back to kind of like where I was I mean my self-destructive behaviors weren't coming directly at the expense of my physical health they were coming at the expense of my emotional health but I actually think there were a lot of people who have very similar stories to mine but their manifestation is it's coming at the expense of their physical health they are sabotaging their ability they they're coming up with a million excuses why they can't eat well they can't exercise they can't do this they can't do that and so you have to be able to get to the root of the problem and so there are many patients where we just think look you're not going to get better without trauma-based therapy like until you come up with a way to care enough about yourself to stop punishing yourself in this way because I think people punish themselves in different ways you could almost argue I used to punish myself by overdoing all of those healthy things like some of the exercise I was doing was actually a form of punishment so on the surface you'd say boy that guy's really healthy but no he wasn't another thing I always think about is when we're in the spirit of trying to build new habits sometimes perfect is the enemy of good typically what I want is a win and I think that what people just need is a win and it doesn't have to be the biggest win it just has to be Owen so if you're looking at a person for whom nothing is optimal don't try to fix all things at once pick the one thing that you think they have the greatest odds of being able to make a difference on and just work on that and accept the fact that the other things will continue to be sub-optimal but you develop their confidence in that one thing how about for 20 minutes a day you do something active you go and walk for 20 minutes a day if you're talking about a person who's never lifted a finger that would be a huge win and you might do that before you get into the details of this type of training or that type of training or we're going to tweak your nutrition and optimize your protein intake I mean that's just overwhelming and you're probably just more likely to fail at everything and create kind of a compensatory negative reaction but again I I don't think there's a pain by numbers approach I think you in the way we do it with patients I think you just have to treat everybody individually and by the way when something's not working you have to accept it and pivot and try something that is I think that's the keyword pivot yeah that's the keyword everyone uh Peter the book is called outlive the science and odd of Longevity if you don't already have it please go and grab a copy uh I I highly recommend it of course today's conversation has been fantastic I've tried to touch on topics that Peter may not have been asked about in a million different interviews he's got fantastic interviews out there on so many awesome podcasts as well so if you're more interested in the parts we didn't cover please do go and watch those and get informed uh Peter it's been such a joy sitting down with you today honestly there's been a moments where I've been mind blown in moments where I've been taken aback and felt really you know in my body and really present where my feet are and uh I'm just really grateful that we got to have this conversation we got to share so much incredible insights with our community today and I want you to make sure that you tag me and Peter on Instagram on tick tock on threads uh with what you're learning what you've taken away what are the things you're going to apply and practice with what's something you're going to experiment with this week that would make me really happy is that you just take one thing away from this and you're like I'm gonna try that out I've got to figure this out for myself that would be an awesome place to start Peter we end every episode with a final five a Fast Five so these questions have to be answered in one word to one sentence Max uh so Peter is here these are your final five or your Fast Five the first question is what is the best health advice you've ever heard or received exercise every day second question what is the worst Health advice you've ever heard or received do a cleanse ah interesting why that's interesting yeah okay oh I just think that you know I've seen I've seen some of those things go really bad where people you know get really mucked up and dehydrated and I've seen people actually take in some chemicals and compounds that dramatically alter liver function tests and things like that wow okay all right uh question number three what's something you're currently trying to unlearn continuing to work on perfectionism yeah unlearning or detuning it uh question number four what's something that you're a very big proponent of but a lot of people may disagree with you and you'll they're like I'm not sure about it maybe the importance of very heavy strength training in post-menopausal women interesting let's dive into that because that's that's fascinating I'm really yeah I have a specific you and that's great women post-menopause are so unbelievably susceptible to osteoporosis and osteopenia with the loss of estrogen unfortunately many any women in that situation are not getting hormone replacement therapy and so they're doubly susceptible to it I think there's just a cultural belief that you know women don't need to lift weights and if they do it's very light but the truth of it is you really need to lift heavy things to make your bones stronger and that doesn't mean it has to be complicated stuff like squats or deadlifts or things like that but you know one of the most important things is carrying doing a farmer's carry so holding very heavy dumbbells in your hands and walking so important and it doesn't matter how old you are got it great Fifth and final question if you could create one law that everyone in the world had to follow what would it be you must go into nature for at least an hour a day with no electronics and just be just be outside be in nature but be untethered to Electronics or obvious distractions beautiful Peter that's fantastic thank you so much again for your time your energy your presence today I hope this is the first of many times that you'll come back on on purpose and again if you don't already follow Peter Peter where's the best place you'd like be able to find you I know you're on Instagram and YouTube and everywhere but yeah I think everything is Peter attia MD is all the handles everywhere and uh yeah so thank you very much I really appreciate this thank you if you love this episode you'll enjoy my interview with Dr Daniel Amen on how to change your life by changing your brain if we want a healthy mind it actually starts with a healthy brain you know I've had the blessing or the curse to scan over a thousand convicted felons and over a hundred murderers and their brains are very damaged

Channel: Jay Shetty Podcast

Views: 506,222

Keywords: Jay Shetty, Jay Shetty Podcast, Jay Shetty Interview, On Purpose Podcast, Jay Shetty Inspiration, Jay Shetty Motivation, Jay Shetty Video, Self help, Self improvement, Self development, entrepreneur, purpose podcast, peter attia, peter attia longevity, peter attia podcast, dr peter attia, peter attia longevity interview, dr. peter attia, peter attia diet, peter attia lifespan, peter attia healthspan, peter attia fasting for longevity, supplements, on purpose peter attia

Id: obpp0d6m7LU

Length: 91min 15sec (5475 seconds)

Published: Mon Aug 07 2023